Texas Commission on Environmental Quality Registration and Certification for Permits by Rule Form PI-7-CERT Instructions Table of Contents Introduction ............................................................................................................................... 1 Overview ..................................................................................................................................... 1 A PBR may be claimed when both the following conditions are met: .................................................................1 To claim a PBR, you may: ................................................................................................................................... 2 Keeping Records ................................................................................................................................................. 2 Tips for a Speedy Administrative Review ........................................................................................................... 2 Small Business Information and Agency Contacts ...................................................................... 2 Instructions for Form PI-7-CERT ................................................................................................ 2 I. Registrant Information ..................................................................................................... 2 II. Facility and Site Information ............................................................................................ 3 III. Fee Information ................................................................................................................4 IV. Technical Information Including State and Federal Regulatory Requirements ................ 5 V. Delinquent Fees ............................................................................................................... 8 VI. Signature for Registration and Certification: ................................................................... 8 VII. Copies of the Registration and Certification: ................................................................... 8 Page i PI-7 CERT Instructions Introduction The primary purpose of the Form PI-7-CERT is to provide all administrative and technical information needed by the Air Permits Division (APD) to evaluate Permits by Rule (PBR) claims that include certification of federally enforceable emission limits. These instructions are intended for use by applicants and consultants to help you prepare a complete PBR registration claim that includes certification of federally enforceable emission limits. The review of your project will go faster if you provide all necessary documents and information requested in the Form PI-7-CERT and in the Core Data Form (TCEQ No. 10400). This form can be used to register and establish federally enforceable emissions limits related to a specific facility or to a whole site. If certification and federally enforceable emission limits are not needed, use Form PI-7. If a facility meets a historical Standard Exemption, meets a Standard Permit, or is otherwise authorized by a permit action, but needs to establish a federally enforceable limit, the Form APD-CERT entitled Certification of Emission Limits (not Form PI-7-CERT) should be used. For more information about certification versus registration see our Certification Fact Sheet on our Fact Sheets for Permits by Rule web page at www.tceq.texas.gov/permitting/air/guidance/pbr/pbr_factsheets.html. Overview Texas Commission on Environmental Quality (TCEQ) regulates facilities that release air contaminants, even in small amounts, under its air permit rules. Facilities with emissions that do not meet de minimis criteria but will not make a significant contribution of air contaminants to the atmosphere may be permitted by rule. Facilities authorized by PBR must be constructed and operated with certain restrictions. A PBR claim must meet both the general and specific requirements in Title 30 Texas Administrative Code (30 TAC) Chapter 106, but does not require an extensive technical review. See the Fact Sheet - Air Quality Permitting at www.tceq.texas.gov/assets/public/permitting/air/factsheets/permit_factsheet.pdf for a list of all potential air permit authorizations. Refer to the Decision Support System at www.tceq.texas.gov/permitting/air/nav/air_supportsys.html for additional information to assist you in determining some of the other state or federal requirements you may need to know. Note: As of June 1, 2014, all PBR registration responses will be sent via e-mail within one business day of TCEQ’s decision – unless a hard copy is specifically requested. The company official must initial section I.B. of the registration form if a hard copy is requested. ePermits: The TCEQ encourages using the online TCEQ e-Services system at www.tceq.texas.gov/e-services for a more simplified way to register your PBR, pay PBR registration fees, and receive PBR registrations. Oil and gas sites registering facilities under 30 TAC § 106.352(a)-(k) are required to use the ePermits system according to 30 TAC § 106.352(f). Hard copies of applications will not be accepted. To use the online system you need to have an active State of Texas Environmental Electronic Reporting System (STEERS) account. Access STEERS at www3.tceq.texas.gov/steers/. For help with ePermits refer to the TCEQ STEERS ePermits Help web page at www3.tceq.texas.gov/steers/help/epr/eprmain.html. A PBR may be claimed when both the following conditions are met: 1. the facility meets all applicable requirements of 30 TAC § 106.4. These requirements limit the amount of annual emissions to less than federal permit major source levels, and require compliance with all state and federal regulations; and 2. the facility meets all applicable conditions of one or more individual PBRs contained in 30 TAC Chapter 106. These requirements may specify design requirements for certain facilities, production or material use limits, and operational restrictions. TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically Page 1 of 8 PI-7-CERT Instructions To claim a PBR, you may: 1. 2. 3. begin construction immediately if the PBR does not require registration; begin construction when the Form PI-7-CERT and attachments are submitted to the TCEQ if the PBR requires registration, but does not require site approval; or not begin construction until you are notified by the TCEQ if the PBR requires registration and written site approval. If you are already operating and still need an air authorization, you should begin steps to seek an authorization. Keeping Records Once a PBR is claimed and/or registered, you should: 1. 2. maintain sufficient records to demonstrate compliance with the annual emissions limits; and maintain sufficient records to demonstrate compliance with the emission limits and specific conditions of the PBR. Refer to the applicable PBR checklist for records retention guidance. Tips for a Speedy Administrative Review The administrative review process will be more efficient and streamlined if you follow the suggestions outlined in the Fact Sheet – Tips for a Speedy Administrative Review at www.tceq.texas.gov/permitting/air/guidance/permit-factsheets.html. Small Business Information and Agency Contacts For agency contacts, see Contact Information for Air Permit Applications (including Environmental Assistance Division) at www.tceq.texas.gov/assets/public/permitting/air/airapp-contacts.pdf Instructions for Form PI-7-CERT These instructions are provided to assist the regulated community to accurately complete a registration request to claim a PBR. I. Registrant Information A. Company or Other Legal Customer Name: Registrations are claimed by either the facility owner or operator, commonly referred to as the “registrant.” List the legal name of the company, corporation, partnership, or person who is claiming the PBR. Applicants can verify the legal name with the Texas Secretary of State at (512) 463-5555, or at www.sos.state.tx.us. The TCEQ will also verify the legal name with the Texas Secretary of State. You may be asked to correct the name provided on the Form PI-7-CERT, if found to be different. In some cases, we may request a copy of the legal document forming the entity to verify the legal name; for example: general partnership filed with the county. B. Company Official Contact Information: Provide the name, title, mailing address, telephone number, fax number, and e-mail address of the company official contact. The company official must not be a consultant. It is important to provide the e-mail address since copies of registrations will be e-mailed. All PBR registration responses will be sent via e-mail within one business day of TCEQ’s decision– unless a hard copy is specifically requested. The company official must initial section I.B. of the registration form if hard copy is requested. C. Technical Contact Information: Provide the name, title, company, mailing address, telephone number, fax number, and e-mail address of the person TCEQ should contact for technical questions. This person must have the authority to make binding agreements and representations on behalf of the registrant. The technical contact may be a consultant. TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically. Page 2 of 8 PI-7-CERT Instructions II. Facility and Site Information A. Name and Type of Facility: Enter the name of the facility for which the PBR is being claimed. The name should be descriptive and indicate the general type of operation, manufacturing process, equipment, or facility which would be authorized under the PBR (include any numerical designation, if appropriate). The name must be descriptive and specific. Examples of acceptable names are, “Sulfuric Acid Plant,” “No. 5 Steam Boiler,” “Electric Arc Furnace No. 2,” and “Fiberglass Boat Manufacturing Facility.” Vague names such as, “Chemical Plant” and “North Process Area” are not acceptable names. Also, check the appropriate box indicating the type of facility as either permanent or temporary. Hot mix asphalt plants and trench burners are typical temporary facilities; a petroleum storage tank would be considered a permanent facility. For portable units, please provide the serial number(s) of the equipment being authorized. B. Facility Location Information: Provide the street address of the facility, if available. If there is no street address, describe the physical location with specific written directions. Identify the location by distance and direction from well-known landmarks, such as highway intersections. It is very important to also include the city and county where the facility will be located. If the address is not located in a city, then enter the city or town closest to the facility even if it is not in the same county as the facility. The county indicated must be the county where the facility is physically located. Please include the ZIP Code of the physical facility site, not the ZIP Code of the applicant's mailing address. In some cases, the TCEQ may request a map showing the location of the facility during the review of the PBR registration. C. TCEQ Core Data Form: We require that you submit a Core Data Form (TCEQ Form Number 10400) on all incoming applications unless the following are met: 1. Regulated Entity and Customer Reference Numbers have been issued by the TCEQ and; 2. No core data information has changed. Information required on the Core Data Form includes the following: Customer Reference Number (CN): This is a unique number given to each business, governmental body, association, individual, or other entity that owns, operates, is responsible for, or is affiliated with a regulated entity. We assign the CN when a Core Data Form is initially submitted. Regulated Entity Number (RN): This is a unique agency assigned number given to each person, organization, place, or thing that is of environmental interest to us and where regulated activities will occur. The RN is assigned when a Core Data Form is initially submitted, if the agency has conducted an investigation, or if the agency has issued an enforcement action. The RN replaces existing air account numbers. The RN for portable units is assigned to the unit itself, and that same RN should be used when applying for authorization at a different location. Note: The company and facility site information provided on the Core Data Form must be the same as provided on the Form PI-7-CERT. D. TCEQ Account Identification Number: This number was assigned by the TCEQ to the entire property owned or controlled by the applicant at a specific location. A typical example of an air quality account number is JB-1234-R. Portable facilities are assigned account identification numbers which begin with a number, such as 92-1234-K. Provide your TCEQ account identification number if known. E. Permit by Rule Number(s) Claimed under 30 TAC Chapter106: Provide the individual rule number(s) that are being claimed. The Form PI-7-CERT can be used to register more than one PBR at a time. TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically. Page 3 of 8 PI-7-CERT Instructions F. Historical Standard Exemption or PBR: Indicate if you are claiming a historical standard exemption or PBR. If “YES,” enter the rule number(s) and the associated effective date. G. Previous Standard Exemption or PBR Registration Number: If this registration is for a change to an existing facility previously authorized under a standard exemption or PBR, list the previous standard exemption number(s) or PBR registration number(s), and the associated effective date. Also attach additional information on whether the facility still meets the previous standard exemption or PBR, or whether a new registration is required and the previous standard exemption or PBR should be voided. H. Other Facilities at this Site Authorized by Standard Exemption, PBR, or Standard Permit: To properly track how this registration may relate to other authorizations or compliance with TCEQ PBR regulations, it is important to list all standard exemption number(s), PBR registration number(s), or Standard Permit registration number(s), and the associated effective date. I. Other Air Preconstruction Permits: If the registration is located at a site that has any other minor or federal NSR air preconstruction permits, list all permit numbers. J. Affected Air Preconstruction Permits: If the PBR being claimed directly affects any permitted facility, list the affected preconstruction permit numbers. K. Federal Operating Permit (FOP) Requirements (30 TAC Chapter 122 Applicability): Information and guidance on applicability of 30 TAC Chapter 122 can be accessed on our Program Applicability web page at www.tceq.texas.gov/permitting/air/titlev/pro_applicability.html. 1. If this PBR results in an increase in the site’s potential-to-emit and renders the site a major source as defined in 30 TAC Chapter 122, an FOP application is required. Check the appropriate box if you are submitting a GOP or SOP application or revision application. Guidance on submitting these applications is available on the Guidance for Title V Operating Permits web page at www.tceq.texas.gov/permitting/air/nav/air_titlevopperm.html. 2. Identify the type(s) of FOP(s) issued for the site by checking the appropriate box. In addition, check the appropriate box if any General Operating Permit (GOP) or Site Operating Permit (SOP) application(s) for the site, including revision applications, is currently under review. If you have questions about the applicability of 30 TAC Chapter 122 or impact of this Form PI-7-CERT on your existing FOP, please contact the TCEQ APD at (512)239-1250, and ask to speak with someone in the Operating Permits Section. III. Fee Information The TCEQ has a fee for all air quality PBR registrations (30 TAC § 106.50). If a new facility, or changes to an existing facility, meets the conditions of a PBR that does not require registration, but the owner/operator wishes to have the TCEQ review and confirm that the facility meets the conditions of the PBR, a fee is required. The fee requirements do not allow for PBR fee refunds. All fees must be paid prior to processing any PBR registration and may be paid by check, money order, or through the TCEQ online payment application (ePay) located at www.tceq.texas.gov/epay. The TCEQ also accepts electronic transfers. Multiple facilities and PBRs at a single site may be claimed under a single form; in these cases, only a single fee is required. TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically. Page 4 of 8 PI-7-CERT Instructions See the PBR Registration Fees Fact Sheet at www.tceq.texas.gov/assets/public/permitting/air/Guidance/NewSourceReview/PermitsByRule/fee fact.pdf for a summary of requirements and exceptions for fees in 30 TAC § 106.50. A. Fee Requirements: There are three exceptions to paying a PBR fee, as described below. 1. A facility applying for a PBR does not have to pay a fee if the registration is solely to establish a federally enforceable emission limit. If a registration is for construction or modification of a facility, which has not been previously reviewed by the TCEQ, a fee is required. 2. If any administrative or subsequent changes occur at the site or the company is addressing any deficiencies that were requested in the initial review the company has 6 months to resubmit without paying an additional fee. 3. A facility applying for a PBR does not have to pay a fee if the registration is for a remediation project (30 TAC § 106.533). For more information about remediation projects see our Checklist for Water and Soil Remediation, 30 TAC 106.533 (TCEQ Form - 10148) at www.tceq.texas.gov/permitting/air/forms/permitbyrule/checklist/sub_x_checklists.html. B. Fee Amount: There are two fee amounts possible under the rules, as follows: 1. An owner/operator of a small business (corporation, partnership, sole proprietorship) that is independently owned and operated, formed for the purpose of making a profit, has fewer than 100 employees or less than $6 million in annual gross receipts is required to submit a $100.00 fee. In addition, an owner/operator that is a governmental entity (city, township, school district) with a population less than 10,000 according to the most recent census is required to submit a $100.00 fee. Finally, non-profit organizations pay a $100.00 fee. 2. All other registrations are required to submit a $450.00 fee. C. IV. Payment Information: Enter the check, money order, transaction number, or voucher number from ePay. Enter the individual or company name printed on the check, and the fee amount paid for this registration. Indicate if the fee was paid online. Technical Information Including State and Federal Regulatory Requirements If any of the technical information below is not included with this submittal, it may result in an automatic deficiency and voiding of the project. Additionally, any essential information (lab analysis, NAAQS compliance demonstrations, etc.) that is needed to confirm that facilities are meeting the requirements of the PBR, must be included. Attachments should include detailed demonstrations of compliance with all requirements. A. PBR Requirements: You must demonstrate compliance with the following: General requirements in 30 TAC §106.4, and Individual requirements of the specific PBR. To assist you with preparing technical information, review our Air Permits by Rule Applicability Quick Checklist or Full Checklist at www.tceq.texas.gov/permitting/air/forms/permitbyrule/checklist/applicability_checklists.ht ml and the Registration Checklists for Permits by Rule web page at www.tceq.texas.gov/permitting/air/forms/permitbyrule/checklist/pbr_checlists_index.html. These checklists contain important information on emission limits, typical methods to calculate emissions, records retention, and other state and federal rules, regulations, and standards that may apply to your facility. Use of the checklists is optional; however, your review will go faster if you supply the applicable checklists. TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically. Page 5 of 8 PI-7-CERT Instructions B. Confidential Information: Texas Health and Safety Code § 382.041 requires us not to disclose any information related to manufacturing processes that is marked “Confidential”. Mark any information related to secret or proprietary processes or methods of manufacture as “Confidential,” if you do not want this information in the public file. All confidential information should be separated from the PBR registration and submitted as a separate file within the same submittal. Additional information regarding confidential information can be found at www.tceq.texas.gov/permitting/air/confidential.html. C. Process Flow Diagram: Provide a process flow diagram so that the permit reviewer can verify all technical information regarding the affected facility. The process flow diagram should be sufficiently descriptive so the permit reviewer can determine the raw materials to be used in the process; all major processing steps and major equipment items; individual emission points associated with each process step; the location and identification of all emission abatement devices; and the location and identification of all waste streams (including wastewater streams that may have associated air emissions). Block flow diagrams generally are not sufficient except for very simple facilities such as boilers. Alternate material flows and changes in routing of emissions during periods of planned MSS should be depicted as well as any alternate emission control devices that will be used during these periods. D. Process Description: Provide a process description to accompany the process flow diagram that discusses each step in the process and provides a step-by-step explanation of exactly how your business operates. The description should lead the permit reviewer through the process with emphasis on where the emissions are generated, why the emissions must be generated, what air pollution controls are used (including process design features that minimize emissions), and where the emissions enter the atmosphere. The process description must also explain how the facility or facilities will be operating when the maximum possible emissions are produced. For some source types, this will probably be the highest production rate. For other source types, the maximum emission rates may occur at partial load. When applicable, discuss cycle times, reaction times, temperatures, pressures, material flow rates, and production rates. Be specific, and do not use generalities such as a small amount, sometimes, and occasionally opened. The process description must also include how the facility is operated during periods of planned MSS and what emission reduction techniques will be used to limit emissions, changes in character of emissions, and the frequency and duration of each type of planned MSS activity. All information in the process description is an enforceable representation. E. Maximum Emissions Data and Calculations: Represent the maximum hourly and total annual emission rates of the project, including emission rates for planned MSS facilities and related activities. You must also provide a demonstration of expected continuous compliance with the represented emission rates. The permit reviewer must be able to duplicate all emission calculations to verify and confirm emissions data and rates represented in the application. Supporting calculations and the technical bases for the emission rates are required. Include all emission rates calculations and any assumptions made in determining the emission rates. List and discuss planned MSS activities separately. Provide emission rates and supporting emissions information from planned MSS activities, frequency, and duration of all planned MSS activities, and all planned MSS activity effects on emission rates. Additionally, note all emission points unique to MSS activities. Maximum hourly emission rates, in pounds per hour, from planned MSS should be based on the maximum rates expected from the MSS activities. Annual planned MSS emission rates, in tons per year, should be based on the number of expected MSS activities during any consecutive 12-month period. TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically. Page 6 of 8 PI-7-CERT Instructions Maximum hourly emission rates, in pounds per hour, should be based on the maximum (design) production capacity of the facility. Dividing the annual emissions in tons per year by the annual hours of operation in order to determine hourly emissions in pounds per hour is often unacceptable and inaccurate since this approach typically underestimates hourly emissions. Maximum annual emission rates, in tons per year, should reflect the operation of the facility throughout any consecutive 12-month period with consideration given to future facility growth. Include a discussion of the hours of operation and how the hours of operation relate to emission rates on an hourly and annual basis. If the process is a non-continuous batch operation, or there are widely varying operating scenarios, clearly identify and account for the variations in emissions in the maximum hourly and annual emission rates. Supply additional information to describe the emission variations, particularly for emissions from MSS facilities and related activities. Include emission rate information for each air contaminant during production operations and during periods of planned MSS. Contaminants must be specifically identified. For example: methanol rather than hydrocarbons or polyester/styrene resin dust and iron dust rather than dust. Provide applicable Material Safety Data Sheets (MSDS), Safety Data Sheets, Air Quality Data Sheets, or equivalent supporting documents that provide complete speciation for all mixtures that contain potential air contaminants. If spreadsheets are used to estimate emissions, they should be formatted such that they are clear and easy to follow and include example calculations with units and the data sources for the inputs. The permit reviewer may request an electronic version of the spreadsheet to verify the emission calculations are correct. F. Certified Emissions: Emissions can be certified for an entire site or specific facilities. It is important for the company to represent what is actually being certified with this form. If the entire site is not being certified, the company should include a summary of facilities that are in this certification. The summary should include emission rates for all emissions points and be supplemented by documentation which demonstrates the basis for each emission rate. This may include: calculations, emissions factors, equipment capacity, fuel consumption, sampling and monitoring data. G. Table 1(a): A completed Table 1(a) – Emission Point Summary (TCEQ Form 10153) must be submitted with all incoming certifications. H. Distance from Property Line and Nearest Off-Property Structure: Instead of an area map and plot plan, the TCEQ requests distance information, including the distance from the facility’s emission release points to the nearest property line and off-property structure. This information is needed as many PBRs have very specific distance limitations. Note: In limited cases, a map or drawing of the site and surrounding land use may be requested during the technical review or at the request of the TCEQ Regional office or local air pollution control program during an investigation. I. Project Status: In an effort to prioritize PBR projects, please check the appropriate box based on if the project has been implemented or if waiting on a response from TCEQ before proceeding with the project. J. Projected Start of Construction and Projected Start of Operation Dates: Provide the projected start of construction date and projected completion date. Note: Construction is broadly interpreted as anything other than site clearance or site preparation. Activities such as land clearing, soil load-bearing tests, leveling of the area, TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically. Page 7 of 8 PI-7-CERT Instructions sewers and utility lines, road building, power line installation, fencing, and construction shack building are considered site clearance or preparation. Equipment may be received at a plant site and stored, provided no attempt is made to assemble the equipment or connect it to any electrical, plumbing, or other utility system. All work, such as excavation, form erection, or foundations upon which facilities will rest is considered construction. Submit any questions regarding the definition of start of construction to airperm@tceq.texas.gov with copies to the appropriate TCEQ regional office and any local air pollution control program(s) having jurisdiction. Each request for clarification must be in writing with sufficient detail to identify the specific activity in question, and the agency response to this request must be in writing for the authorization to be valid. Additional information can be found at www.tceq.texas.gov/permitting/air/newsourcereview/before.html. V. Delinquent Fees and Penalties We will not process your application until all delinquent fees and applicable penalties owed to the TCEQ or the Office of the Attorney General on behalf of the TCEQ are paid in accordance with the Delinquent Fee and Penalty Protocol. More information regarding delinquent fee and penalties can be found at www.tceq.texas.gov/agency/delin/index.html. VI. Signature for Registration and Certification: The company official identified in Section I.B. must sign all copies of the application. The applicant’s consultant cannot sign the application. If this project has a capital cost of more than $2,000,000.00, this application must be submitted under the seal of a Registered Texas Professional Engineer (P.E.) or the appropriate exemption must be claimed pursuant to the Texas Engineering Practice Act. The company official’s signature confirms knowledge of the facts included in the application, and affirms the facts contained in the application are true and correct. The signature also signifies awareness that intentionally or knowingly making false statements or representations in the application is a criminal offense subject to criminal penalties. Note: Signatures must be original and in ink. Signatures may not be reproduced by photocopy, fax, or other means. The original signature must be received before any permit is issued. Applicants may check application receipt and status using the New Source Review Air Permits web page at www2.tceq.texas.gov/airperm/index.cfm?fuseaction=airpermits.start. For questions relating to the initial receipt and administrative review of the application, please contact the Air Permits Initial Review Team at (512) 239-1250. VII. Copies of the Registration and Certification: Submit copies of the Form PI-7-CERT, and all other required attachments, as indicated on the PI-7-CERT form. Retain a copy of the registration for your own records. Failure to distribute copies of the registration will delay processing. The original of this registration and certification form must be sent to the TCEQ in Austin and copies sent to the appropriate TCEQ regional office and any local air pollution control program(s) with jurisdiction. A copy must also be maintained on-site. For sites that normally operate unattended, a copy must be maintained at an office within Texas that has operational control of the site. Also, all subsequent correspondence should be copied to the TCEQ regional office and local air pollution control program(s), as appropriate. Do not attach a copy of Form PI-7-CERT to subsequent correspondence unless specifically requested, as this may cause another registration file to be created. Indicate the assigned TCEQ registration number, TCEQ regulated entity number, and permit reviewer, if known, on all subsequent correspondence. TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically. Page 8 of 8 Texas Commission on Environmental Quality Certification and Registration for Permits by Rule Form PI-7-CERT (Page 1) I. Registrant Information A. Company or Other Legal Customer Name: B. Company Official Contact Information ( Mr. Mrs. Ms. Other ) Name: Title: Mailing Address: City: State: ZIP Code: Phone: Fax: E-mail Address: All PBR registration responses will be sent via e-mail unless a hard copy is specifically requested. The company official must initial here if hard copy is requested. (please initial) C. Technical Contact Information ( Mr. Mrs. Ms. Other ) Name: Title: Company Name: Mailing Address: City: State: Phone: ZIP Code: Fax: E-mail: II. A. Facility and Site Information Name and Type of Facility Facility Name: Type of Facility: Permanent Temporary For portable units, please provide the serial number of the equipment being authorized below. Serial No: B. Serial No: Facility Location Information Street Address: If there is no street address, provide written driving directions to the site and provide the closest city or town, county, and ZIP code for the site (attach description if additional space is needed). City: County: TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically. ZIP Code: Page _____ of _____ Texas Commission on Environmental Quality Certification and Registration for Permits by Rule Form PI-7-CERT Page 2 II. Facility and Site Information (continued) C. TCEQ Core Data Form Is the Core Data Form (TCEQ Form Number 10400) attached? YES NO YES NO YES NO If “NO,” provide customer reference number (CN) and regulated entity number (RN) below. Customer Reference Number (CN): Regulated Entity Number (RN): D. TCEQ Account Identification Number (if known): E. PBR number(s) claimed under 30 TAC Chapter 106 (List all the individual rule number(s) that are being claimed.) 106. 106. 106. 106. 106. 106. F. Historical Standard Exemption or PBR Are you claiming a historical standard exemption or PBR? If “YES,” enter rule number(s) and associated effective date in the spaces provided below. Rule Number(s) G. Effective Date Previous Standard Exemption or PBR Registration Number Is this authorization for a change to an existing facility previously authorized under a standard exemption or PBR? If “YES,” enter previous standard exemption number(s) and PBR registration number(s), and associated effective dates in the spaces provided below. Standard Exemption and PBR Registration Number(s) H. Effective Date Other Facilities at this Site Authorized by Standard Exemption, PBR, or Standard Permit Are there any other facilities at this site that are authorized by an Air Standard Exemption, PBR, or Standard Permit? YES NO If “YES,” enter standard exemption number(s), PBR registration number(s), and Standard Permit registration number(s), and associated effective date in the spaces provided below. Standard Exemption, PBR Registration, and Standard Permit Registration Number(s) TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically. Effective Date Page _____ of _____ Texas Commission on Environmental Quality Certification and Registration for Permits by Rule Form PI-7-CERT Page 3 II. Facility and Site Information (continued) I. Other Air Preconstruction Permits Are there any other air preconstruction permits at this site? YES NO YES NO If “YES,” enter permit number(s) in the spaces provided below. J. Affected Air Preconstruction Permits Does the PBR being claimed directly affect any permitted facility? If “YES,” enter the permit number(s) in the spaces provided below. K. Federal Operating Permit (FOP) Requirements (30 TAC Chapter 122 Applicability) 1. Is this facility located at a site that is required to obtain an FOP pursuant to 30 TAC Chapter 122? YES NO To Be Determined If the site currently has an existing FOP, enter the permit number: Check the requirements of 30 TAC Chapter 122 that will be triggered if this certification is accepted. (check all that apply) Initial Application for an FOP Significant Revision for an SOP Operational Flexibility/Off Permit Notification for an SOP To be Determined 2. Revision for a GOP None Identify the type(s) of FOP issued and/or FOP application(s) submitted/pending for the site. (check all that apply) SOP GOP N/A SOP application/revision (submitted or under APD review) III. A. Minor Revision for an SOP GOP application/revision (submitted or under APD review) Fee Information (See Section VII. for address to send fee or go to www.tceq.texas.gov/epay to pay online.) Fee Requirements Is a fee required per Title 30 TAC § 106.50? YES NO If “NO,” specify the exception (check all that apply) 1. Registration is solely to establish a federally enforceable emission limit. YES NO 2. Registration is within six months of an initial PBR review, and it is addressing deficiencies, administrative changes, or other allowed changes. YES NO 3. Registration is for a remediation project (30 TAC § 106.533). YES NO TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically. Page _____ of _____ Texas Commission on Environmental Quality Certification and Registration for Permits by Rule Form PI-7-CERT Page 4 III. Fee Information (See Section VII. for address to send fee or go to www.tceq.texas.gov/epay to pay online.) (continued) B. Fee Amount 1. A $100 fee is required if any of the answers in III.B.1 are “YES.” This business has less than 100 employees. YES NO This business has less than 6 million dollars in annual gross receipts. YES NO This registration is submitted by a governmental entity with a population of less than 10,000. YES NO This registration is submitted by a non-profit organization. YES NO YES NO 2. A $450 fee is required for all other registrations. C. Payment Information Check/money order/transaction or voucher number: Individual or company name on check: Fee Amount: $ Was fee paid online? IV. Technical Information Including State And Federal Regulatory Requirements Place a check next to the appropriate box to indicate what is included in your submittal. NOTE: Any technical or essential information needed to confirm that facilities are meeting the requirements of the PBR must be provided. Not providing key information could result in an automatic deficiency and voiding of the project. A. PBR requirements (Checklists are optional; however, your review will go faster if you provide applicable checklists.) Did you demonstrate that the general requirements in 30 TAC § 106.4 are met? YES NO Did you demonstrate that the individual requirements of the specific PBR are met? YES NO B. Confidential Information (All pages properly marked “CONFIDENTIAL”) YES NO C. Process Flow Diagram YES NO D. Process Description YES NO E. Maximum Emissions Data and Calculations YES NO Note: If the facilities listed in this registration are subject to the Mass Emissions Cap & Trade program under 30 TAC Chapter 101, Subchapter H, Division 3, the owner/operator of these facilities must possess NOx allowances equivalent to the actual NOx, emissions from these facilities. TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically. Page _____ of _____ Texas Commission on Environmental Quality Certification and Registration for Permits by Rule Form PI-7-CERT Page 5 IV. Technical Information Including State And Federal Regulatory Requirements (continued) Place a check next to the appropriate box to indicate what is included in your submittal. Note: Any technical or essential information needed to confirm that facilities are meeting the requirements of the PBR must be provided. Not providing key information could result in an automatic deficiency and voiding of the project. F. Is this certification being submitted to certify the emissions for the entire site? YES NO YES NO If “NO,” include a summary of the specific facilities and emissions being certified. G. Table 1(a) (Form 10153) Emission Point Summary H. Distances from Property Line and Nearest Off-Property Structure Distance from this facility’s emission release point to the nearest property line: feet Distance from this facility’s emission release point to the nearest off-property structure: feet I. Project Status Has the company implemented the project or waiting on a response from TCEQ? J. Implemented Waiting Projected Start of Construction and Projected Start of Operation Dates Projected Start of Construction (provide date): Projected Start of Operation (provide date): V. Delinquent Fees This form will not be processed until all delinquent fees and/or penalties owed to the TCEQ or the Office of the Attorney General on behalf of the TCEQ is paid in accordance with the Delinquent Fee and Penalty Protocol. For more information regarding Delinquent Fees and Penalties, go to the TCEQ Web site at: www.tceq.texas.gov/agency/delin/index.html. VI. Signature For Registration And Certification The signature below confirms that I have knowledge of the facts included in this application and that these facts are true and correct to the best of my knowledge and belief. I further state that to the best of my knowledge and belief, the project for which this application is made will not in any way violate any provision of the Texas Water Code (TWC), Chapter 7; the Texas Health and Safety Code, Chapter 382, the Texas Clean Air Act (TCAA); the air quality rules of the Texas Commission on Environmental Quality; or any local governmental ordinance or resolution enacted pursuant to the TCAA. I further state that I understand my signature indicates that this application meets all applicable nonattainment, prevention of significant deterioration, or major source of hazardous air pollutant permitting requirements. The signature further signifies awareness that intentionally or knowingly making or causing to be made false material statements or representations in the application is a criminal offense subject to criminal penalties. Name (printed): Signature (original signature required): Date: TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically. Page _____ of _____ Texas Commission on Environmental Quality Form PI-7-CERT Certification and Registration for Permits by Rule VII. Submitting Copies of the Certification and Registration Copies must be sent as listed below: Processing delays may occur if copies are not sent as noted. Who Where What Air Permits Initial Review Team (APIRT) Regular, Certified, Priority Mail MC 161, P.O. Box 13087 Austin, Texas 78711-3087 Hand Delivery, Overnight Mail MC 161, 12100 Park 35 Circle, Building C, Third Floor Austin, Texas 78753 Originals Form PI-7-CERT, Core Data Form, and all attachments. Not required if using ePermits1 Revenue Section, TCEQ Regular, Certified, Priority Mail MC 214, P.O. Box 13088 Austin, Texas 78711-3088 Hand Delivery, Overnight Mail MC 214, 12100 Park 35 Circle, Building A, Third Floor Austin, Texas 78753 Original Money Order or Check, Copy of Form PI-7-CERT, and Core Data Form. Not required if fee was paid using ePay2. Appropriate TCEQ Regional Office To find your Regional Office address, go to the TCEQ Web Copy of Form site at www.tceq.texas.gov/publications/gi/gi-002.html, PI-7-CERT, Core Data Form, or call (512) 239-1250. and all attachments. Appropriate Local To Find your local or Regional Air Pollution Control Copy of Form Air Pollution Programs go to the TCEQ, APD Website at PI-7-CERT, Core Data Form, Control Program(s) www.tceq.texas.gov/permitting/air/local_programs.html, and all attachments. or call (512) 239-1250 1 2 ePermits located at www3.tceq.texas.gov/steers/ ePay located at www.tceq.texas.gov/epay TCEQ-20182 (APDG 5379v17, Revised 07/15) PI-7-CERT This form is for use by facilities subject to air quality permit requirements and may be revised periodically. Page _____ of _____